Article
Influence of intraoperative validation of bowl microperfusion on surgical decision making in colorectal surgery
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Authors
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David Koch
- Chirurgische Klinik I, CBF, Charité, Allgemein-, Gefäß- und Thoraxchirurgie, Berlin, Deutschland
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Martin E. Kreis
- Chirurgische Klinik I, CBF, Charité, Allgemein-, Gefäß- und Thoraxchirurgie, Berlin, Deutschland
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Jörn Gröne
- Chirurgische Klinik I, CBF, Charité, Allgemein-, Gefäß- und Thoraxchirurgie, Berlin, Deutschland
| Published: | April 21, 2016 |
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Outline
Text
Background: Limited bowl perfusion is a major reason for anastomotic leakage accounting for substantial morbidity and mortality in colorectal surgery. Exact intraoperative assessment of microperfusion may have an impact on the surgeon´s intraoperative management and leakage rate.
Materials and methods: The objective of this single center observational study was to implement and integrate indocyanin green (ICG) based fluorescence detection with Pinpoint Perfusion Imaging in a series of consecutive rectal cancer patients who underwent laparoscopic anterior and lower anterior resection with primary anastomosis during a five-months period.
Results: Intraoperative fluorescence angiography for colorectal microperfusion was feasible. No adverse effects have been documented. Assessment of perfusion imaging influenced surgical decision making in one third of the patients, of which all patients showed primary healing of the anastomosis. We found an overall leakage rate of 5% with one leakage of a colorectal anastomosis in all patients.
Conclusion: Intraoperative fluorescence angiography is an accurate tool for assessing microperfusion and has an influence on surgical decision making in colorectal anastomosis.
